Written by Aleksandra Agranovich
Fraxel Laser Indications for Skin Treatment
The Fraxel Laser, also known as fractional photothermolysis, is a dermatological tool that has been proven safe an effective for the treatment of facial photodamage, acne scaring, hypopigmentation, and dyspigmentation. Fractional photothermolysis works by creating “spatially precise microscopic thermal wounds (using a 1550-nm erbium fiber laser) that targets water-containing tissue to effect the photocoagulation of narrow, sharply defined columns of skin known as microscopic thermal zones” (Tanzi, 2008). Treatment with the Fraxel Laser involves multiple sessions mainly because each session only treats a small portion of the skin. Typically, patients may return for additional sessions within a three to six-month course.
There are two different types of lasers that exist for fractional photothermolysis which include ablative and non-ablative therapy. Ablative lasers involve the use of carbon dioxide or erbium and are well tolerated for facial rejuvenation. However, over time, ablative lasers may cause loss of the cutaneous barrier function and prolonged recovery. Non-ablative systems, on the other hand, are a bit safer than ablative lasers, and have a reduced risk of skin cell damage. This technique involves the use of “1064- and 1320-nm Nd:YAG, intense pulsed light systems combined with epidermal surface cooling and infrared or near-infrared wavelengths” (Tanzi, 2008).
How to Take Care of your Skin After Fraxel Laser Treatment
After receiving a Fraxel Laser therapy session, it is important to stay hydrated and void smoking, alcohol consumption, heavy sweating, swimming, and sun exposure. The treated area needs to remain clean and free of makeup, alcohol-based products, and detergents. Post Fraxel Laser recovery tends to take about one full week and many patients may experience redness, burning, throbbing, and peeling of the skin within the first two days. Overall, the Fraxel Laser is a great technique that may rejuvenate the skin, remove acne scaring, and allow patients to feel confident about their appearance. The Fraxel laser was first introduced in 2003 and has become a very effective treatment for different types of facial conditions. The side effects of this procedure are typically mild and can result in erythema and a slight darkening of the skin. According to various Fraxel studies, severe complications are rare.
Resources
Tanzi EL, Wanitphakdeedecha R, Alster TS. Fraxel laser indications and long-term follow-up. Aesthet Surg J. 2008;28(6):675-680. doi:10.1016/j.asj.2008.09.006
Janik JP, Markus JL, Al-Dujaili Z, Markus RF. Laser resurfacing. Semin Plast Surg. 2007;21(3):139-146. doi:10.1055/s-2007-991182
Bertossi D, Giampaoli G, Lucchese A, et al. The skin rejuvenation associated treatment-Fraxel laser, Microbotox, and low G prime hyaluronic acid: preliminary results. Lasers Med Sci. 2019;34(7):1449-1455. doi:10.1007/s10103-019-02738-z
Fraxel Laser (Fractional photothermolysis)
Fractional photothermolysis is a “new skin resurfacing laser technology for treating rhytids (wrinkles), melanocytic pigmentation, scars, and photodamaged skin.” Not only is the procedure done with the use of lasers, but it has been improved for certain setbacks that were present when using cutaneous laser resurfacing (ablative), making this technique both safer and more effective. Fractional photothermolysis is “performed using a 1550-nm erbium fiber laser (Fraxel; Reliant Technologies, Mountain View, CA) that targets water-containing tissue to effect photocoagulation of narrow, sharply defined columns of skin known as microscopic thermal zones (MTZs), at depths of 200 μm to 500 μm and spaced at 200- to 300-μm intervals.” However, as with any procedure, there are certain side effects and complications to be aware of. These side effects are mild, but can include “erythema and periocular edema, and a slight darkening of the skin (bronzing) as the MEND desquamate.” MEND is referring to the formation of microscopic epidermal necrotic debris, which begins to exfoliate days after the procedure. The process of the exfoliation gives the skin a darker or bronzed appearance, which is to be expected. Redness and swelling will result due to irritation and general uncomfortableness from the lasers, which is expected to resolve within days. There has not yet been any reports of permanent pigmentary alteration or scarring after the healing process has ended. Overall, the general complications are much less than those associated with the aftermath of ablative laser skin resurfacing.
In the case of treating wrinkles and unwanted melanocytic pigmentation, visible improvements and changes were observed. After the treatment sessions, patients’ skin texture and color became more uniform throughout the target spot, showing results they were anxiously waiting to see. For those who wished to reduce the appearance of wrinkles, after treatment sessions with the fractional photothermolysis, the wrinkles began to become less noticeable. All these results were achieved with “minimal downtime for the patient” which is the optimal situation. According to the Aesthetic Surgery Journal, “Over the next several years, variations on the theme of fractional photothermolysis, including ablative fractional photothermolysis with highly advanced CO2 and Er:YAG laser systems, will continue to advance cutaneous laser resurfacing toward the ultimate goal of maximum clinical improvement coupled with minimal recovery and side effects.” Although the results obtained with the fractional photothermolysis are better than previous procedures, there is always room to improve and do better.
Tanzi, Elizabeth, and Rungsima Wanitphakdeedecha. “Fraxel Laser Indications and Long-Term Follow-Up.” Academic.Oup.Com, academic.oup.com/asj/article/28/6/675/225729?login=true. Accessed 16 Aug. 2023.
SS;, Collawn. “Fraxel Skin Resurfacing.” Annals of Plastic Surgery, pubmed.ncbi.nlm.nih.gov/17471124/. Accessed 16 Aug. 2023.